Complete Blood Picture (CBP), EDTA Whole Blood

Complete blood picture test or cbp test means, it is done as a routine screening test, when there are signs and symptoms related to the conditions that effect the blood cells (RBC's, WBC's and Platelets), when suspecting infections like malaria, microfilaria etc., helps to diagnose various conditions like anemia, leukemia, bleeding disorders, infections and to monitor the effectiveness of treatment after the diagnosis is establish (example: to monitor the effect of iron therapy / blood transfusion in microcytic anemia, effect of chemotherapy or radiation therapy in leukemias etc., ) Complete blood picture test (CBP) includes various parameters like haemoglobin, hematocrit, red blood cell (RBC) count, white blood cell (WBC) count, differential WBC count, platelet count, mean platelet volume (MPV), RBC indices like MCV (Mean corpuscular volume), MCH (Mean corpuscular hemoglobin), MCHC (Mean corpuscular hemoglobin concentration) and RDW (Red cell distribution width). The morphology and distribution of blood cells and detection of hemoparasites like malaria, microfilaria are also included. RBC parameters helps in detecting and differentiating various types of anemias. Hemoglobin is a proteins present in the RBCs and is responsible for the transport of oxygen in the blood. Hematocrit is the ratio of volume of RBCs to the total volume of blood. Mean corpuscular volume (MCV) represents the average volume of a single red blood cell. Mean corpuscular hemoglobin (MCH) is the average amount of haemoglobin in each red blood cell. Mean corpuscular hemoglobin concentration (MCHC) represents the average concentration of haemoglobin in a given volume of packed red cells. Red cell distribution width (RDW) is the degree of variation of red cell size. WBCs are part of bodys defence system against infections and cancer. White blood cells are neutrophils, lymphocytes, eosinophils, basophils and monocytes. Platelets play a vital role in the blood clotting process and hence decreased platelet count results in bleeding manifestations. Mean platelet volume (MPV) represents average size of platelets.

1. What other tests are useful in case if CBP is abnormal?

when WBC is abnormal, tests like ESR, C reactive protein, blood culture, urine culture and sputum culture are useful if suspecting infections, and bone marrow studies, immunophenotyping may be needed in leukemias, myelodysplasia etc.

Abnormal RBC results may need additional test like reticulocyte count, iron studies, serum vitamin B12 and serum folate, or Hb electrophoresis in suspecting hemoglobinopathies.

Abnormal platelet counts may need additional tests like Immature Platelet Fraction, platelet function tests and coagulation tests.

2. What is Immature Platelet Fraction (IPF)?

Platelets are produced in the bone marrow and only after they mature, platelets are released in to the blood. When there is decreased platelet count in the blood, the immature or the reticulated platelets are released into blood before complete maturation and IPF is defined as the relative number of immature platelets in the blood. IPF is useful in determine the cause of a thrombocytopenia. The thrombocytopenia can be due to decreased production of platelets by bone marrow (where IPF is low) or due to increased destruction of platelets (where IPF is high).

3. What are immature granulocytes (IG) or what does a shift to left means?

White blood cells are produced in the bone marrow and only after they mature, are released in to the blood. Immature granulocytes are the white blood cells that are not developed completely and released into the blood. Presence of these cells in the blood is called as a shift to the left. They include metamyelocytes, myelocytes, promyelocytes etc. These are seen in conditions like infections, blood cancer etc.